Neoplasia

Question 1

What is neoplasia? This leads to the formation of what?

Answer 1

• Means “new growth”, used to denote uncontrolled growth of cells who can’t be controlled by normal regulatory mechanisms seen in normal tissues.
• proliferation of neoplastic cells leads to formation of masses called TUMORS, latin meaning swelling.

Question 2

What is the greek word for the study of cancer? The scientific word?

Answer 2

-Greek word for swelling is “Onkos” which leads to scientific term: ONCOLOGY

Question 3

are neoplasia and tumor the same?

Answer 3

they are used synonymously, BUT not all neoplasms are tumors (leukemias) and not all swellings are neoplasms.

Question 4

What are the two ways tumors are classified?

Answer 4

CLINICALLY-takes into account presentation of patient and out comes of disease or
HISTOLOGICALLY- gives the morphologic make-up of the neoplasm.
Both lead to the criteria for diagnosing tumors as benign or malignant.

Question 5

What is the difference between benign and malignant tumors?

Answer 5

Benign-have limited growth potential and good outcome, think COMPRESS.
Malignant-grow uncontrollably and may eventually kill the host. think SUPPRESS.

Question 6

Who/what determines the definitive diagnosis of tumors ALWAYS??

Answer 6

diagnosis of whether benign or malignant is ALWAYS achieved by the PATHOLOGIC examination.

Question 7

What are the 4 major macroscopic features of benign tumors?

Answer 7

1. sharply demarcated from normal tissue
2. often encapsulated by connective tissue
3. have expansile growth
   4 usually compress the normal, surrounding tissue.

Question 8

What are the features of malignant tumors as compared to benign tumors?

Answer 8

• Lack a capsule
• not sharply demarcated from normal tissue
• cannot be removed as easy as benign tumors because of their infiltrative growth and lack of sharp borders.

Question 9

TQ!!!** What are the 2 hallmarks of malignant tumors grossly?

Answer 9

the invasion of surrounding tissue by infiltration cause “HEMORRHAGE and NECROSIS” within the tissue.

Question 10

What are the histologic features of benign tumors?

Answer 10

Benign tumors are composed of cells that resemble the tissue from which they have arisen.
-a uniform population where all the cells have the same features, with regularly shaped round or oval nuclei, same size, evenly-distributed chromatin with normal nucleoli and well-developed cytoplasm. they may be a little darker purple though.

Question 11

What are the histologic features of malignancy?

Answer 11

Malignant cells show prominent anaplasia in that they have new features not inherent of the origin tissue. They are UNDIFFERENTIATED, embryonic or anaplastic (very immature)

Question 12

what are the malignant tumor disorganized cellular findings?

Answer 12

pleomorphism or variability-different shapes, sizes. A hetorgeneous population of cells

• uneven hypercrhomatic nuclei that vary in shapes and sizes, usually larger, multiple nucleoli
• no specialized cytoplasmic function and exhibit very little cytoplasm.

Question 13

What is a “high nuclear/cytoplasmic ratio” (high N/C ratio)? what kind of tumors have this? what about the nucleoli of these tumors and why does this happen? (slide 30)

Answer 13

• large nucleus surrounded by a thin rim of cytoplasm, with a ratio of 1:1 instead of normal 1:5 ratio.
• prominent nucleoli because of the vast number of cells undergoing mitosis (rapid growth and replication).

Question 14

What is the definition of metastisis? (slide 33)

Answer 14

where cells move from one site to another in the body. A spread of malignant tumor cells from primary location to another site in the body.

Question 15

What kind of tumor cells metastisize? what is an exception to this?

Answer 15

• malignant tumors

- malignant primary brain tumors

Question 16

What are the three main pathways malignant cells spread (metastasize)? Give an example of each pathway

Answer 16

1. lymphatics (breast cancer)
2. bloodstream (many cancers)
3. direct extension of primary tumor, usually seeding on surface of body cavities (renal cell carcinoma seeding to adrenal gland)

Question 17

How are benign tumors named (conceptually)? What suffix to benign tumors USUALLy have?

Answer 17

• Benign tumors named according to the cell type which they resemble most, with addition of
• OMA.

Question 18

What suffix do benign epithelial or glandular tumors have? what about squamous tissues specifically? examples of each

Answer 18

• “-ademoma”-colon tubular adenoma

- “Papilloma”-skin or laryngeal papillomas

Question 19

What suffix would be used for connective tissue. how would you name cartilage tissue? osseous tissue? smooth muscle? fat tissue?

Answer 19

“oma”

• chondroma
• osteoma
• leiomyoma
• lipoma

Question 20

What name is used for malignant epithelial tumors? what are 5 examples?

Answer 20

• “carcinoma”

- squamous cell carcinoma, adenocarcinoma, transitional cell carcinoma.

Question 21

What are some examples of adenocarcinomas that are named differently? (4) (slide 54)

Answer 21

renal cell carcinomas
adrenocortical carcinomas
hepatocellular carcinomas

Question 22

How are malignant connective tissue tumors named? fibrous tissue? fat tissue? bone tissue? skeletal muscle?

Answer 22

• “sarcoma”
• fibrosarcoma
• liposarcoma
• osteosarcoma
• rhabdomyosarcoma

Question 23

What are 5 exceptions to the malignant tumor naming rules?

Answer 23

1. Mesotheioma (epithelial tumor from chronic asbestos exposure)
2. lymphomas
3. melanomas
4. astrocytomas (pimary brain tumor)
5. seminomas(testicular)

Question 24

Another exception to malignant naming is pediatric tumors. what is the suffix? 3 examples?

Answer 24

• Blastomas

- retinoblastomas, neuroblastomas (adrenal medulla),, and medulloblastomas (midline of the cerebellum)

Question 25

Where are teratomas and teratocarcinomas derived from? where are they usually found? other places? what are common things found inside of them?

Answer 25

• derived from all three germ cell layers (ecto, meso, endoderm)
• usually in ovaries or testes
• may also be seen in midline of body (mediastinum or sacrococcygeal region)

Question 26

Some malignant cells are named after their discoverer, name 3.

Answer 26

• hodgkin’s lymphoma
• ewing’s sarcoma of the bone
• Kaposi’s sarcoma of the skin

Question 27

what is histologic grading based on? what is analasia determined by?
WHO is grading of cancer done by?

Answer 27

• the degree of anaplasia and number of proliferating cells
• determined by the shape and irreglarity of cells, large numbers of atypical mitoses, nuclear pleomorphism, and tumor giant cells
• the PATHOLOGIST

Question 28

How many grades of malignancy are there? What does each grade mean?

Answer 28

3
grade I- tumors well-differentiated
grade II-moderatelly differentiated
grade III-poorly or undifferentiated

Question 29

can a tumor be well differentiated but still malignant?

Answer 29

yes

Question 30

What determines the choice of a medical vs a surgical treatment approach to cancer?

Answer 30

the stage of the tumor or the extend of spread

Question 31

who determines cancer staging? what does staging tell you?

how is it determined?

Answer 31

• the oncologist
• the extent of tumor spread
• physical examination, radiographic studies, and biospsy results, and teh size and grading of the primary tumor, and presense and absence of lymph node and distant metastisis

Question 32

what does the TNM cancer staging system tell you?

Answer 32

• Tumor size
• Lymph node status
• metastisis

Question 33

what does the TNM system depend on?

Answer 33

which primary organ is involved, tumor size, extent of local spread within organ, lymph node metastisis, and distant metastisis.

Question 34

what factor of metastisis mandates more aggressive treatment?

Answer 34

lymph node metastisis

Question 35

what is a contraindication to surgical intervention?

Answer 35

presense of distant metastisis

Question 36

what is palliation?

Answer 36

the clinician can’t do anything more to help the patient other then help them die comfortably